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Early identification of HCV genotype 1 patients responding to 24 weeks peginterferon α‐2a (40 kd)/ribavirin therapy
Author(s) -
Jensen Donald M.,
Morgan Timothy R.,
Marcellin Patrick,
Pockros Paul J.,
Reddy K. Rajender,
Hadziyannis Stephanos J.,
Ferenci Peter,
Ackrill Andrew M.,
Willems Bernard
Publication year - 2006
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.21159
Subject(s) - ribavirin , medicine , gastroenterology , hepatitis c virus , peginterferon alfa 2a , genotype , hepatitis c , randomized controlled trial , immunology , virus , biology , biochemistry , gene
Approximately one third of hepatitis C virus (HCV) genotype 1 patients achieved a sustained virological response (SVR) after 24 weeks of treatment with peginterferon α‐2a (40 kd) plus ribavirin in a randomized, multinational trial. We aimed to identify factors associated with a rapid virological response (RVR) at week 4 (HCV RNA <50 IU/mL) and a SVR (HCV RNA <50 IU/mL at the end of follow‐up) in these patients. Stepwise multiple logistic regression analysis was used to explore the prognostic factors for a RVR and SVR in genotype 1 patients treated for 24 weeks. Fifty‐one of 216 (24%) genotype 1 patients in the 24‐week treatment groups had a RVR. SVR rates were considerably higher in patients with than without a RVR (89% vs. 19%, respectively). Patients with a baseline HCV RNA of less than 200,000 IU/mL (OR 9.7, 95% CI 4.2‐22.5; P < .0001) or 200,000‐600,000 IU/mL (OR 3.6, 95% CI 1.5‐9.1; P = .0057) were more likely to achieve a RVR than those with HCV RNA greater than 600,000 IU/mL. HCV subtype (1b vs. 1a) was also independently associated with RVR (OR 1.8, 95% CI 0.9‐3.7; P = .0954). RVR (OR 23.7 vs. no RVR, 95% CI 9.1‐61.7) and baseline HCV RNA less than 200,000 IU/mL (OR 2.7 vs. >600,000 IU/mL, 95% CI 1.1‐6.3; P < .026) were significant and independent predictors of SVR in patients treated for 24 weeks. In conclusion , patients infected with HCV genotype 1 and treated with peginterferon α‐2a/ribavirin sustained a RVR 24% of the time. This portends an 89% probability of a SVR after 24 weeks of treatment. (H EPATOLOGY 2006;43:954–960.)